The effects of evidence-based fall prevention strategies on nurses' attitudes towards evidence-based nursing practice and patient falls

Objective: The purpose of this study is to examine the effects of evidence-based fall prevention strategies that implemented according the Advancing Research & Clinical Practice Through Close Collobariton Model to nurses attitudes towards evidence-based nursing practice, patient fall rates and evaluate nurses' opinions about evidence-based fall prevention strategies after implementation. Method: The quasi-experimental study, using single-group pretest-posttest design and repeatitive assesment, was conducted in January 2015-May 2017 in an educational research hospital which is connected to the Ministry of Health. The hospital has 414 nurses and 554 patient beds. In this study, evidence based fall prevention strategies according to the Advancing Research & Clinical Practice Through Close Collobariton Model were implemented. In addition, strategies have been reinforced with facilitators / reminders such as giving lectures, creating a social media group, posters and brochures. Within the scope of the evaluation of the inteventions; 101 nurses scale means were measured before intervention and 3-6 months after intervention. However, observations were made at 3 and 6 months after the intervention (n = 60 patients) and at the third month of the intervention, nurses' opinions on evidence-based fall prevention strategies (n = 17 nurses) were taken. The quarterly fall numbers for the years 2015-2016 were used as the corporate output. As data collection tools in the study; Nurses Attitudes Towards Evidence-Based Nursing, Evidence-Based Fall Prevention Intervention Observation Form, Patient Fall Rates Data Sheet and Evidence-Based Patient Falls Prevention Strategies Semi-Structured Questionnaire were used. For the analysis of quantitative data; descriptive statistics, variance analysis in repetitive assessments and test for the significance of two mean scores. For qualitative data content analysis method was used. Findings: In the study; nurses attitudes towards evidence based nursing before intervention has been found at high level. A statistically significant difference was found in the attitudes of the nurses towards the evidence based nursing according to the time before the intervention and the 3rd and 6th months after the intervention. But there was no significant difference found between nurses attitudes towards evidence based nursing that reporting or not reporting the falls. 71.3% increase has been achieved on the evidence based fall prevention interventions used by nurses. According to hospital annual records, the fall rates for 2015 was 34 and for 2016 was 39. To evaluate the effectiveness of evidence-based fall prevention strategies in the qualitative study; three main themes and 13 categories were created, namely "facilitators", "obstacles" and "suggestions". Conclusions: Evidence based fall prevention strategies implementation according to the Advancing Research & Clinical Practice Through Close Collobariton Model, have a positive impact on the nurses' attitudes towards evidence-based nursing and increased their use of evidence-based fall prevention interventions. It has been found that there is no change in the first six months of the reported fall rates for 2015 and 2016, but an increase has been found in the second six months. It is believed that the nurses' opinions taken at the evaluation of the effectiveness of the evidence-based fall prevention strategies will be effective by ensuring participation of all health professionals in the creation of a patient safety culture and solving infrastructure problems. For future studies, it may be advisable for all health professionals should be aware of patient falls.